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SHANNON SULLIVAN DDS
NPI 1407267164
Dentist in New York, NY

Active since May 15, 2014PECOS Enrolled
100 HAVEN AVE, NEW YORK, NY 10032(212) 342-0107 Get Directions Write a Review

NPPES record last updated: September 14, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shannon Sullivan Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON SULLIVAN DDS (NPI 1407267164) is an individual dentist in New York, New York, licensed in Ohio (024571) and active in the NPI registry since May 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407267164
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameSHANNON SULLIVANCredential: DDS
Location Address100 HAVEN AVENew York, NY 10032-2645
Mailing Address100 Haven AveNew York, NY 10032-2645
Phone(212) 342-0107
Sole ProprietorYes
Enumeration DateMay 15, 2014
Last NPPES UpdateSeptember 14, 2016
✔ NPI 1407267164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in OH · 024571
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
100 HAVEN AVE, New York, NY 10032
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Sullivan Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10032 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARGARITA PAPPAS D.D.S.
Dentist (General Practice)
100 HAVEN AVE, APT 30 E
NEW YORK, NY 10032
New York County (212) 927-2155
MR. JOSEPH MARSALLO
Student in an Organized Health Care Education/Training Program
100 HAVEN AVE
NEW YORK, NY 10032
New York County (212) 305-6100
SCHONMEI WU
Student in an Organized Health Care Education/Training Program
100 HAVEN AVE, APARTMENT 23F
NEW YORK, NY 10032
New York County (713) 435-9214
DR. STEPHEN SHOU-CHING KAM M.D.
Student in an Organized Health Care Education/Training Program
100 HAVEN AVE, APT. 11D
NEW YORK, NY 10032
New York County (917) 601-0356
DR. COLIN TAO MENG PSYD, LCSW
Psychologist (Clinical)
100 HAVEN AVE
NEW YORK, NY 10032
New York County (310) 435-8690
STEPHANIE CHRISTINA JANKLY
Registered Nurse
100 HAVEN AVE, APT 16D
NEW YORK, NY 10032
New York County (626) 226-8733
DR. CHRISTINE MARIE O'HEA DMD MDS
Dentist (Orthodontics and Dentofacial Orthopedics)
100 HAVEN AVE
NEW YORK, NY 10032
New York County (212) 342-0107
EILEEN CSAKANY RN
Registered Nurse
100 HAVEN AVE
NEW YORK, NY 10032
New York County (212) 342-2375

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Sullivan's NPI number?

The NPI number for Shannon Sullivan is 1407267164. It was assigned to this individual provider in the NPPES registry on May 15, 2014.

Where is Shannon Sullivan located?

Shannon Sullivan practices at 100 Haven Ave, New York, NY 10032. The listed phone number is (212) 342-0107.

What is Shannon Sullivan's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Shannon Sullivan enrolled in Medicare?

Yes. Shannon Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Sullivan was last updated on September 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.